Recognizing Child Abuse and Neglect

In honor of National Child Abuse Prevention Month (April), I have spent some time thinking about how we, as juvenile justice professionals approach our responsibilities for the protection of children. Most of us hold positions that make us mandatory reporters and even if we didn’t our personal ethics would have us picking up the phone if we suspected that a child was being abused or neglected. Some of the worst calls that law enforcement takes are the ones that involve an injury or death of a child at the hands of an adult that should have taken care of them. These calls create disgust, disbelief and anger. Each of us would hope that if we came upon a situation where a child was being abused we would recognize it and therefore be able to help. Here are a few things to remember as we go about our personal and professional mission to protect and help the most vulnerable among us.

Scope

Many of us believe we are doing a good job of recognizing and stopping cases of child abuse and neglect. Unfortunately it seems when you look at the statistics, there are so many that fly under the radar. The issue of child abuse is immense and so many American children face hurtful words and hands within their own homes. An article in the Salem (IN) Leader begins with the statement, “Count to 10. Somewhere in the United States, someone just reported a child being abused.” And that’s the ones that are reported. Childhelp, a leading national non-profit organization dedicated to helping victims of child abuse and neglect report some harrowing statistics:

More than four children die every day as a result of child abuse

It is estimated that 50-60% of child fatalities due to maltreatment are not recorded as such on the death certificate

Approximately 70% of children that die from abuse are under the age of 4

More than 90% of juvenile sexual abuse victims know their perpetrator in some way

About 30% of abused and neglected children will later abuse their own children continuing the horrible cycle of abuse

Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions and at all levels of education

Child abuse and neglect are all around us and those of us who work with children, whether in the schools, social agencies or juvenile justice want to be able to recognize when a child before us needs help. Sometimes we just have a feeling that something is just not right. There are some common factors to detecting when a child needs help.

If they aren’t cruising, they shouldn’t be Bruising

Therese Sirles, a representative from Kosair Children’s Hospital, Director of the Children’s Hospital Foundation Office of Children’s Advocacy and a 35-year veteran pediatric nurse recently gave a talk on recognizing the signs of abuse in children. Her strongest message revolved around very young children. She believed the number attributed to deaths from child abuse was actually low due to unseen signs of abuse especially in infants. Bruising in infants is one of those often missed signs. “If they aren’t cruising, they shouldn’t be bruising,” she explains. When a child is not mobile, bruising shouldn’t be occurring. Children who die of Shaken Baby Syndrome often have bruising patterns indicating the abuse. Sirles also explained a good litmus test for abusive bruising patterns called the TEN-4 test. This is bruising to the Torso, Ears or Neck in children who are 4 or under or any bruising in infants 4 months old or under (those that aren’t cruising). Keeping an eye out for these marks on children can help identify children who are being abused. "It's very, very, very rare for children to die on the first situation of abuse," Sirles tells her audience. "Child abuse is an escalation of violence over time that results in death or disability."

Neglect

According to the National Child Abuse and Neglect Data System (NCANDS) 78.3% of the child maltreatment reports to state child protection services involved victims suffering from neglect. 69.9% of child fatalities were attributed to neglect only or a combination of neglect and another maltreatment type. Although not always as recognizable as a bruised face or broken bone, there are signs that we can look for that indicate a child is being neglected:

Not enough food-child looks malnourished, is begging or stealing food, acts hungry or complains of hunger, and/or is constantly fatigued, listless or falls asleep in class

Lack of supervision-child left home for long periods, states they have no caretaker, extended stays at school (arrives early; stays late) and/or child left not knowing where their caretaker is or when he/she will return

These are just a few signs. Many more exist that we should be on the lookout for. The signs apply not only to young children but teenagers as well. These signs don’t necessarily indicate that a child is being neglected but should encourage us to ask more questions.

Getting in Trouble or Troubled

Speaking of teenagers, juvenile justice professionals often come into contact with older children when they make poor choices and/or are misbehaving or committing criminal and status offenses. This is another time for us to stop and consider whether abuse/neglect could be at the root of these behaviors. According to Childhelp, “14% of all men in prison and 36% of women in prison in the USA were abused as children, about twice the frequency seen in the general population” and “children who experience child abuse & neglect are about 9 times more likely to become involved in criminal activity.” Even some of the indicators of abuse and neglect exhibit themselves as behaviors putting children in contact with authorities including truancy, prostitution, drug/alcohol use and running away.

Most of us pride ourselves on the ability to recognize and help children who need us. We never want to have the hollow, defeated feeling that would come from the death of a child we came into contact with and didn’t recognize their need. By keeping our eyes open, we can help the children that need us. Hopefully, with this diligence, we can see the numbers of child abuse and neglect that have continued to rise and rise finally drop and children will be safe.